While Jammu and Kashmir government has posted a large number of doctors and paramedical staff on the Amarnath Yatra duty, this year a number of doctors from different states have also joined them.
“This year we see positive change as a good number of doctors from outside J&K have joined us,” said a doctor posted in Baltal area. He said previously also doctors from outside used to join J&K health department to provide medical help to the pilgrims. “But this year their numbers have gone up. I saw doctors from AIIMS, Pondicherry, Punjab and other areas working with us,” he added.
However, doctors complain that pilgrims don’t follow the health advisories leading to complications. “We guide them. We boost their morale. But most of them are in a hurry to take a trek. Some of them, who are diabetic and hypertensive, don’t take medicine during pilgrimage which complicates their health-related issues,” says a doctor. The doctors say the pilgrimage don’t acclimatize themselves to the weather conditions and rush to the mountains leading to breathlessness.
The facilities that the state government and health department have provided to the pilgrims include critical care, general surgery, orthopaedics, high altitude emergency, laboratory services, hyperbaric oxygen chamber, portable oxygen concentrators, automated CPR machines, defibrillators, cardiac monitors and transport ventilator to name the few.
As the Amarnath shrine is situated at an altitude of 13,500 feet above sea level, the high altitude trek to the shrine involves exposure to extreme cold, low humidity, increased ultraviolet radiations and reduced air pressure, many yatris face respiratory and other related medical problems.
The pilgrims have to trek a distance of 32 km from Chandanwari (Pahalgam route) and 14 km from Baltal to reach the Amarnath shrine.
In July 2012, the Supreme Court constituted Special High Powered Committee (SHPC) cited non-acclimatization as one of the reasons responsible for High Altitude Sickness that leads to deaths during the yatra. It also cited religious traditions like devotees taking an ice-cold water bath in the morning and then taking a trek with empty stomach responsible for the deaths. The SHPC had made more than 20 recommendations including that all pilgrims should furnish Compulsory Health Certificates while seeking registration for the pilgrimage and no one below the age of 13 years or above the age of 75 years and no lady with 6 week’s pregnancy should be allowed to undertake the yatra. However, official sources say the guidelines are being violated. “Serious issues for us that they don’t take medicine for diabetes or hypertension,” said a doctor.
“Our staff are fully trained to handle medical emergencies like AMS, HAPE & HACE that frequently occur on such expeditions” said Dr. Arshad Rafi, the officer-in-charge of the yatra.
He said over the years, the number of pilgrims has increased exponentially and so have the requirements of medical facilities for the same particularly since 2010.
He said a three-tier healthcare system is in place to deliver healthcare facilities, each having a minimum set of manpower and equipment back up. “It was perceived that specialized facilities would need to be set up at strategic locations at near equitable distances and in consideration of the pilgrim night halt options and were thus set up at Baltal, Chandanwari, Holy Cave, Sheshnag & Panjtarni. These designated 15 bedded Base Camps hospitals now have the facilities for consultations in Medicine, Surgery, Orthopaedics, Cardiology and Critical Care which was backed up with all required equipment, diagnostics, nursing and referral facilities.”
The second tier of Medical Aid Centres has been created which are manned by trained medical officers and have basic diagnostics and treatment facilities including for the treatment of emergencies. He added that they are set up at 11 locations along both routes focusing on the areas where incidences of morbidity were high.
The third tier of Emergency Aid Centres are mostly located at every 2 km distance along the routes leading to the Holy Cave. “These centres on the analogy of the sub centers at only the basic first aid facilities but were manned by a trained medical officer,” he added.
Doctors, however, demand that they should be given one day off for one working day. “We give 24 hours of duty and we deserve at least one day off,” said a doctor.